A blood test is now available that would enable parents to learn the sex of their fetus at seven weeks. Even more, the results of the test are said to be “highly accurate” if the test is done correctly according to a study published this week in the Journal of the American Medical Association. But the existence of such prenatal tests, and evidence for their accuracy, opens ethical floodgates and raises tough questions: What if parents are set on having a child of a certain gender (a boy, perhaps) but find out they are having a girl?
The blood test analyzes fetal DNA in a mother’s blood and can detect a child’s sex weeks before an ultrasound screening. It is noninvasive unlike amniocentesis which, along with other procedures, carries a small risk of miscarriage. The tests including Consumer Genetics’ “Pink or Blue” tests have been available online and in drug stores for years but their accuracy has not consistently been claimed by the manufacturers. They cost $250 and up; lab fees and shipping costs can add up about a hundred dollars more.
Another company, TrovaGene, is seeking to create a DNA test using urine as well as a test for Down syndrome. None of these tests are currently regulated by the FDA, as they are not used for medical purposes.
As the New York Times notes, such blood tests are “routinely” being used by European doctors in specific cases. London’s Great Ormond Street hospital allows parents to use the tests for male babies tho could have hemophilia.
[Doctors use the tests] to help expectant parents whose offspring are at risk for rare gender-linked disorders determine whether they need invasive and costly genetic testing. For example, Duchenne muscular dystrophy affects boys, but if the fetus is not the at-risk sex, such tests are unnecessary. But doctors in the United States generally have not prescribed the tests because they are unregulated and medical labs are not yet federally certified to use them.
That and other aspects of the pregnancy landscape could change as a result of the new study. The journal study analyzed reams of research on fetal DNA tests — 57 studies involving about 6,500 pregnancies — and found that carefully conducted tests could determine sex with accuracy of 95 percent at 7 weeks to 99 percent at 20 weeks.
The New York Times says that the companies do not sell the tests in China or India where a strong cultural preference for sons over daughters persists.
While sex selection is not considered a widespread objective in the United States, companies say that occasionally customers expressed that interest, and have been denied the test. A recent study of third pregnancies in the journal Prenatal Diagnosis found that in some Asian-American groups, more boys than girls are born in ratios that are “strongly suggesting prenatal sex selection,” the authors said.
At least one company, Consumer Genetics, which sells the Pink or Blue test, requires customers to sign a waiver saying they are not using the test for that purpose. “We don’t want this technology to be used as a method of gender selection,” said the company’s executive vice president, Terry Carmichael. Sex-determination tests are part of a new frontier of fetal DNA testing, which can be used to determine paternity and blood type, and is being used to develop early screening tests for genetic diseases like Down syndrome.
But what people will do with such a test is, of course, up to themselves, whatever they say. Autism, for instance, occurs in four times as many boys as girls; if a family knows is expecting a boy, and has reason to be concerned about that child being autistic (perhaps because the family has an autistic child), might they choose not to have the child?
The BBC quotes Dr Gillian Lockwood, medical director of Midland Fertility Services, as noting that, while “sex selection for social reasons is illegal in the UK,” the existence of the blood tests means that we’re in danger of being on “a slippery slope.” Now that medical experts are confirming the tests’ accuracy, are we already starting to slide down it?
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